Neighbourhoods are fast becoming one of the most important organising principles in public service reform. From the rollout of neighbourhood health centres in the 10 Year Health Plan to family hubs in children’s services, adult social care, neighbourhood policing and the UK Government’s Plan for Neighbourhoods, working at neighbourhood level is now central to how national and local government and the NHS engage with people and communities.
The English Devolution and Community Empowerment Act 2026 goes further, requiring local authorities to introduce neighbourhood governance arrangements. While neighbourhood health does not expressly appear within the Health Bill, the guidance Fit for the future: towards population health delivery models sets a clear policy direction for the NHS to organise integrated services around defined populations, improving routine care while supporting long term conditions and providing better alternatives to hospital treatment.
The introductory paragraph to Fit for the future acknowledges patients rightly expect services to be designed in a way that meets their needs and is delivered as close to where they live as possible. But moving integration beyond an ideal into delivery has historically been challenging both as a result of the legal framework and the differing expectations on partners, planning and budgets. NHS organisations and local government will therefore need to think about how they use all the tools at their disposal to successfully deliver neighbourhood where previous attempts at integration may have stalled.
Browne Jacobson has extensive experience of working with local government and NHS bodies on major service transformation projects, structural reorganisation and collaboration arrangements. We understand the legal and governance considerations that lead to success, and how to work alongside our clients to deliver the solutions they need to support the outcomes they aspire to.
While the policy case for neighbourhood working is well established, the legal and practical foundations that allow it to function across organisational boundaries have not been fully explored. That is why we are working with sector partners to address this gap.
"Browne Jacobson maintain a partnering approach to their public sector clients. I have worked closely with many of the team over the last ten years. Their commitment, skill and knowledge have created legacy change across governance, regeneration and service delivery projects."
The 'missing middle' is bridging the gap between national policy ambition and local delivery - the governance arrangements, legal structures, data-sharing agreements, workforce models and commissioning frameworks that organisations need to have in place before neighbourhood working can function effectively. Integration ambitions must move beyond pilots into at scale solutions that empower organisations and the communities they serve to make their own decisions about what and how neighbourhood delivery looks like for them. These foundations are not provided by national guidance, but will determine whether neighbourhood working succeeds or stalls.
Our work concentrates on the 'missing middle', the practical, organisational and legal foundations that allow neighbourhood working to flourish. Rather than revisiting the case for change, we focus on how organisations embed neighbourhood approaches across the whole system. Rather than reinventing the wheel for every pilot we develop structures within which neighbourhood teams have flexibility to respond to local needs and priorities, and which offer leaders assurance and confidence across their organisations.
With neighbourhoods being increasingly understood as the most meaningful level at which public services connect with people’s everyday lives, recognised benefits include:
Government policy is also positioning neighbourhoods as a site of service delivery and governance, spanning local government, the NHS, social care, policing, skills and employment.
Alongside this, councils and health systems are navigating:
The challenge is not whether to work at neighbourhood level, but how to do it well, safely and sustainably, both in terms of long-term financial stability, including multi-year funding commitments that endure beyond political cycles, and environmental and social responsibility.
Because neighbourhood working cuts across organisational and professional boundaries, it raises legal questions that span health law, public law, local government, data, infrastructure, procurement commissioning and workforce. Addressing those questions requires a cross-practice approach - and an understanding of how the law applies not just within organisations, but between them.
At the heart of our neighbourhood working programme is an active research partnership with two national bodies: the Local Government Information Unit (LGIU) and NHS Transformation Unit. Together, we are building an evidence base on what it actually takes to make neighbourhood working operational - from governance and data to workforce and finance. We are exploring the conditions that allow neighbourhoods to develop solutions that meet the needs of their place, through a test, learn, grow approach. The research is designed to produce practical, actionable tools for the sector, not just policy analysis.
Our aim is to help create repeatable, scalable approaches that make neighbourhood working easier to deliver in practice, with emphasis on relationship-focused methods and space to innovate, rather than purely structural reforms.
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Through our strategic partnership with the Local Government Information Unit (LGIU), we are leading a major research programme exploring what it really takes for councils to embed neighbourhood working as an organisational approach.
Including the six research areas
The research draws directly on the experiences of local authorities and system partners, focusing on practical tools, delivery models and organisational enablers. Findings will be published in an accessible public report, alongside events and sector engagement throughout 2026.
The central research question is: what does it actually take for a council to embed neighbourhood working as a standard organisational approach, rather than a project or pilot? The research goes beyond the structural to examine culture, leadership and the day-to-day decisions that determine whether neighbourhood working takes root across a local system.
The research report will be published in the Autumn 2026, with interim findings and sector engagement events throughout the year.
In parallel, we are working closely with NHS Transformation Unit to conduct research to understand how NHS organisations are designing, resourcing, and embedding neighbourhood-level health models. This includes exploring how health systems can create value from scale while strengthening neighbourhood-level services, helping organisations navigate governance, accountability and integration across complex provider landscapes.
This work draws on lessons from existing neighbourhood models, case studies from member organisations, and engagement with key stakeholders to understand how NHS organisations are designing, resourcing and embedding neighbourhood-level health models, with a focus on the NHS-local government interface, enablers to bridge the gap between policy and operational delivery such as workforce and digital, scalability of models, and the citizen and community experience of neighbourhood health - areas where evidence remains underdeveloped but demand for practical guidance is high.
Outputs from this workstream will be published alongside the LGIU research in Autumn 2026 and will include practical frameworks for organisations navigating the organisational design and workforce challenges of neighbourhood working.
Neighbourhood working does not sit neatly within the legal and regulatory frameworks that govern any single organisation. When councils, NHS bodies, VCFSE partners and primary care networks work together at neighbourhood level, questions of accountability, data, contracting and employment arise in ways that existing organisational structures are not always set up to resolve. The sections below set out the key legal and governance challenges we help organisations to address - each linking to fuller guidance.
One of the most persistent questions in neighbourhood working is accountability: Where decisions are made across organisational boundaries, who can make them and who is accountable? How can neighbourhood teams be empowered to make the right decisions with confidence and ease? How can differing priorities between areas and organisations be navigated? Without formal governance arrangements neighbourhood teams can operate in a way that creates real risk for the organisations involved. With overly prescriptive governance, the ability of neighbourhood teams to deliver for their place is diminished.
We help ICBs, councils and NHS providers to design governance and decision-making structures that are legally robust, operationally workable and proportionate to the scale of what they are trying to achieve.
Data sharing is consistently cited as one of the biggest barriers to neighbourhood working - but in our experience, the legal framework is rarely the real obstacle. The challenge is more often a lack of clarity about what is already permissible, combined with an absence of the practical agreements and governance arrangements that make data sharing feel safe. We advise NHS organisations and councils on the lawful basis for sharing health and care data, what UK GDPR requires of multi-agency teams, and how to put information governance arrangements in place that allow neighbourhood working to begin without unnecessary delay.
The shift to neighbourhood working is also reshaping how services are commissioned and contracted. The introduction of Single Neighbourhood Provider and Multi-Neighbourhood Provider contract models, the Health Care Services (Provider Selection Regime) Regulations 2023 and the Procurement Act 2023 have all changed the legal landscape in ways that commissioners and providers are still working through. We help NHS organisations and local authorities to understand how to develop a whole commissioning cycle that supports the procurement and delivery of system models including consideration of when procurement obligations bite, how to structure delegation, alliance and collaborative arrangements including pooling of budgets and joint decision-making within the appropriate legal framework. Such arrangements will become increasingly important as ICBs transition to a strategic commissioning role alongside the evolving regional tier in local government.
Integrating staff across NHS and local authority boundaries raises some of the most complex employment law questions in neighbourhood working. Whether arrangements involve secondment, organisational transfer or the creation of new joint roles and career pathways, the implications for TUPE, terms and conditions, pensions and collective bargaining need to be understood from the outset - not after the workforce model has already been designed. We work with NHS trusts, ICBs and councils to structure workforce arrangements that protect both organisations and their staff, and to navigate the Employment Rights Act 2025 changes that are now reshaping how public sector workforce change is managed.
Neighbourhood health centres sit at the heart of the NHS 10 Year Plan's vision for shifting care out of hospitals and into communities. But establishing a shared facility that brings together services from multiple organisations raises significant legal and regulatory questions - from the legal structure used to hold the estate and the planning consent required, to CQC registration obligations and how running costs and liabilities are allocated between partners.
Neighbourhood assets associated with health and care do not stop at health centres. Sport, social and leisure, green space and the wider built environment all contribute to health and wellbeing, while investment in assets creates opportunities to support regeneration of an area.
We advise NHS organisations and local authorities on the legal and estates dimensions of neighbourhood health centre development, including navigating NHS England's regional approval processes and the land and property transfer arrangements that shared facilities require.
While much of neighbourhood working is about how organisations work with communities, neighbourhoods are also slated to become the route for investment in places. Whether funded by central, regional or local government initiatives, or by private sector investment, neighbourhood arrangements need to allow for inward investment, and management of investment funds at neighbourhood level.
With growing recognition of the role of community assets and community wealth building as ways to support flourishing neighbourhoods, forward thinking authorities have opportunities to consider how inward investment can become the basis for future community wealth.
We have recently worked with CBI on PPP mechanisms which will support the inward investment which many neighbourhoods will need to deliver their ambitions. We advise local government and NHS bodies on their arrangements to secure and manage public and private sector investment, and on outcome based contracting to deliver long term benefits to the people and places for which they are responsible.
"Supporting The Elliot Foundation on their innovative approach to community transformation, proving that schools don't just educate – they anchor communities."Schools in the community
"Although the neighbourhood health framework is primarily addressed to integrated care boards and NHS providers, local authority leaders need to engage with this framework as active participants, not merely as consultees."Key areas for social care
"As someone who works closely with local authorities, NHS organisations and social care commissioners navigating this landscape, I want to share what I see working on the ground, and what still gets in the way."Public sector leader tips
"Over the coming year, Browne Jacobson and the LGIU will collaborate closely on research projects that will provide deep insights into the inner workings of local government, enabling us to respond accordingly in how we support councils in delivering for their people."Joint research projects
We advised Sheffield City Council on its procurement of 16 contracts to replace its previous arrangements for providing home care services within the city, leading the team drafting the contracts and providing strategic procurement advice - including bringing in employment experts to advise on TUPE and overseas workers - both while the procurement was being planned and when a potential challenge situation arose during contract award. Our work ensured the Council was able to replace its entire home care commissioning framework compliantly and efficiently, protecting both service continuity for residents and the Council's legal position when challenged.
We have supported health and care systems to establish Integrated Care Boards, Integrated Care Partnerships, provider collaboratives and place-based governance structures - advising on constitutional documents, terms of reference, and other arrangements for the lawful and efficient delegation of functions, and undertaking wholesale policy reviews and rewrites for a number of ICBs.
We have also advised on the clustering of Integrated Care Boards and the development of Provider and Place collaboratives to support the creation of an integrated health organisational approach. Our work gives ICBs and their partners the legal foundations to devolve decision-making to neighbourhood and place level - a critical enabler of the NHS's integrated neighbourhood health agenda.
We led on the establishment of a regional partnership for Neath Port Talbot Council for a substance misuse and treatment service, comprising eight public bodies, which procured a consortium of partners to deliver a £6 million per annum service - improving outcomes across local government, probation and the prison service. Our work covered the full legal architecture of the multi-body arrangement, from governance and corporate structures through to procurement and contract documentation, enabling public bodies from different statutory frameworks to work together as a single, coherent service for their communities.
We advised the Lancashire and South Cumbria Provider Collaborative - comprising five NHS provider trusts - on its governance arrangements for joint working, delegation, and the establishment of a joint committee and shared corporate services (OneLSC): the first collaborative of its kind in the NHS. Our work established the legal and governance architecture for the collaborative, enabling the five trusts to operate at scale across the health system whilst maintaining accountability. This model has since been adopted as a blueprint for provider collaboratives nationally.
Neighbourhood working refers to the organisation of health, care and public services around defined local communities - typically populations of 30,000 to 50,000 people - rather than around single organisations or institutions. It is central to the government’s 10 Year Health Plan, the Neighbourhood Health Framework and the forthcoming English Devolution and Community Empowerment Act 2026. It matters legally because working at neighbourhood level requires organisations to establish governance arrangements, pool resources, share data, and manage accountability across organisational boundaries - all of which raise complex legal questions.
The 'missing middle' is the gap between national policy ambition and practical local delivery. National guidance sets out what neighbourhood working should achieve, but it does not tell organisations how to structure the governance arrangements, data-sharing agreements, workforce models and contractual frameworks they need to make it work. Filling that gap - practically, legally and sustainably - is where Browne Jacobson concentrates its work.
We are leading two parallel research workstreams: one with the Local Government Information Unit (LGIU) exploring what it takes for councils to embed neighbourhood working as an organisational approach, and one with NHS Transformation Unit focused on how NHS organisations are designing, resourcing, and embedding neighbourhood-level health models. Both programmes will publish reports and host sector events in 2026. If you would like to contribute to the research or register to receive findings, please contact James Arrowsmith at james.arrowsmith@brownejacobson.com.
We work with integrated care boards, NHS provider trusts, local authorities, combined authorities, primary care networks and VCFSE organisations. Our clients span the full spectrum of neighbourhood working - from GP practices and PCNs considering how to best prepare to take on SNP and MNP contracts, ICBs implementing delegation arrangements with NHS provider trusts and VCFSE partners to councils navigating local government reorganisation alongside neighbourhood governance requirements.
Neighbourhood working is not a single-discipline legal question. Depending on the model being developed, it may engage public law considerations for both the NHS and local government (including legal powers, duties and governance) contracting and procurement, employment law and TUPE, information law and property / estates. That cross-practice dimension is one of the reasons neighbourhood working is legally complex - and one of the reasons our multidisciplinary team is structured to address it as a whole, rather than in isolation.
The best starting point is a conversation about where your organisation currently is and what the immediate pressure points are. For some organisations, that is a governance question - how do we structure accountability for decisions made across organisational boundaries? For others, it is a data question, a workforce question or a commissioning question. We offer an initial diagnostic conversation at no charge, through which we can identify the specific legal and governance questions your neighbourhood model raises and agree a practical scope of support. Contact James Arrowsmith or Rebecca Hainsworth using the details below.
